Kelly Serfas, a Certified Veterinary Technician in Bethlehem, PA, contributed to this article.

Screw tail is due to a malformation of one of several vertebrae in the tail. It most commonly occurs in Bulldogs, who have a clear genetic tendency for it. The condition can also rarely occur in pugs, Boston terriers and Manx cats. Other names for the condition include corkscrew tail, ingrown tail, tail fold dermatitis and tail fold intertrigo.

How bad is screw tail?How severe the condition is depends on how deep the tail fold goes. In some cases, screw tail leads to an infected, painful and itchy skin fold. The tail can partially obstruct the anus, in which case feces and anal sac fluid enhance the skin infection. The tail fold may then become painful and itchy. In most cases, the smell is so terrible, that it is sometimes difficult to breathe near the poor dog!

How is screw tail treated?Mild cases may be treated medically or conservatively. Skin fold dermatitis, a skin infection between the folds of skin, can be treated with antibiotics by mouth or inside the skin folds along with daily cleaning of the skin folds. Cleaning involves special shampoos, antiseptics, baths or medicated wipes.

Ironically, while cleaning the skin fold helps treat the infection, it can also make it worse. The reason is that bacteria love the environment inside the skin fold because it is dark, warm and moist. Therefore, any liquid or ointment placed inside the skin fold maintains the moisture level. This is a classic, vicious cycle with no end in sight. Most of the clients I see for this problem are frustrated after months or often years of unsuccessful treatments and sometimes exorbitant veterinary bills. Unfortunately, if the case is severe, medical treatment will not be effective.

Surgery to fix screw tailThe best way to treat a bad case of screw tail is surgery. This entails removing the end of the tail and the infected skin fold in order to end up with a clean area. This is a fairly technical and challenging procedure, which is typically performed by a surgeon.

The challenges include:

Working in a filthy area (both because of the infection in the tail fold and because of the proximity of the anus). We certainly scrub the skin as thoroughly as possible, but there is a mild risk of infection.

Exactly the right amount of skin needs to be sacrificed (enough skin to get rid of all of the infected tissue, and not so much that the skin can’t be stitched up nicely).

Many bulldogs are incapable of licking the area. Therefore, most are very lucky to go home without an E. collar or plastic cone around their necks. However, it can be difficult to prevent these patients from scooting, which may have become a habit after years of itching. Scooting can cause problems with proper healing of the incision.

I also frequently hear concerns about fecal incontinence from colleagues and pet guardians, but this is a very rare complication when the surgery is performed by an experienced surgeon.

Despite the technical challenges, most patients fortunately do very well after surgery. The owner can finally stop cleaning the mess and giving oral medications. The dog can finally enjoy life without being constantly painful and itchy.

If you have any questions or concerns, you should always visit or call your veterinarian -- they are your best resource to ensure the health and well-being of your pets.

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Dr. Phil Zeltzman is a board-certified veterinary surgeon and author. His traveling practice takes him all over Eastern Pennsylvania and Western New Jersey. You can visit his website at www.DrPhilZeltzman.com, and follow him at www.facebook.com/DrZeltzman.